Senior Clinical coding Analyst

Key Responsibilities:

• Analyze and evaluate clinical codes used in the revenue cycle, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and related modifiers.
• Conduct regular audits of coded medical records, ensuring accuracy, completeness, and compliance with relevant coding guidelines, industry standards, and regulations.
• Identify coding discrepancies, documentation deficiencies, and areas for improvement in the coding and revenue cycle processes.
• Collaborate with coding teams, healthcare providers, and revenue cycle stakeholders to resolve coding-related issues, clarify documentation requirements, and ensure accurate code assignment.
• Develop and implement coding quality initiatives, including education and training programs, to enhance coding accuracy, compliance, and productivity.
• Stay up-to-date with the latest changes in coding guidelines, regulations, and industry best practices, and ensure timely implementation of necessary updates within the organization.
• Provide guidance and mentorship to coding staff, assisting in the resolution of complex coding cases, and promoting professional development.
• Generate regular reports and metrics related to coding quality, productivity, and compliance, highlighting areas of concern and recommending actionable improvements.
• Collaborate with IT teams and other stakeholders to optimize coding tools, software, and systems, ensuring seamless integration within the revenue cycle processes.
• Participate in coding-related projects, committees, and cross-functional teams, representing the coding and revenue cycle perspective and contributing to organizational goals.

Qualifications:

• Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or similar certification is required.
• Experience: Minimum of 2-3 years of medical coding or auditing experience and experience with risk adjustment audits, clinical documentation improvement (CDI), and payer audits.
• Knowledge of Coding Systems: Strong knowledge of ICD-10, CPT, and HCPCS coding systems, and familiarity with DRG, E/M coding.
• Bachelor's degree: in Nursing, or any Medical or Health Information Management or a related field.
• Proficient in using coding software, encoders, and electronic health record (EHR) systems.
• Excellent understanding of revenue cycle workflows, including charge capture, billing, claims processing, and reimbursement methodologies.
• Proven track record in conducting coding audits, implementing coding quality improvement initiatives, and achieving measurable outcomes.
• Exceptional attention to detail and accuracy, coupled with excellent organizational and problem-solving skills.
• Effective communication and interpersonal skills, with the ability to collaborate with diverse stakeholders, provide education, and resolve coding-related issues.
• Ability to work independently, prioritize tasks, and meet deadlines in a dynamic and fast-paced environment.
• Proficiency in using coding-related software and tools, as well as a high level of computer literacy.

Join our dynamic organization as a Senior Clinical Coding Analyst, and contribute to the enhancement of coding quality within the revenue cycle, ensuring accurate and compliant coding practices that support optimal healthcare outcomes